Gradual Transition to a Brand New Medical Billing Service

I am opening a medical billing service business in a few months I will be gradually taking over the billing of a Neurosurgeon. The neurosurgeon is currently using another medical billing company.

I would like to understand how the switch can be done gradually and seamlessly as we are trying to avoid letting the current billing company know until I am comfortable with the billing and all that is involved in the day to day of running a successful medical billing company.

Let me know if a gradual transition of taking over the billing process is possible without having the current billing company know of our plan.Thank you,

Response:Claire,

I think a lot of this depends on how the claims are being sent, what software and systems are being used, etc.

Probably the best you can do is to enter practice information, treatment and diagnosis fees, and possibly some patient information in the new system before actually going live.

If you are setting up with a new clearinghouse or payer service, the existing billing service may find out something is up. When we have had clients switch to another billing service, we notice they will stop communicating or be very elusive. That's a good indication to us they are making a change. That's just part of this business. Some clients no matter how hard you work for them, they feel there is a better deal or service. And by then it's best for both parties to part ways.

I know it takes some time to transition to a new system, but eventually the provider will have to stop sending superbills (or however the patient encounter is communicated) to the old billing service and allow you to get started.

When we take on a new client that has been with another billing service, we basically start from scratch and enter each patient as a new patient. One of the biggest challenges in doing this is dealing with the existing account balances and any outstanding payments. It really depends on how cooperative the old billing service is and what kind of agreement the provider has with them. We handle on a case-by-case basis but realistically there's not much we can do if they are not cooperative because they have no obligation to the new billing service. It can be difficult at first but becomes easier with time.